直肠膀胱-乙状结肠腹壁造口术的疗效观察

Effect of rectum-bladder-sigmoid colon abdominal ostomy

目的：探讨直肠膀胱-乙状结肠腹壁造口术的疗效。方法：对47例直肠膀胱-乙状结肠腹壁造口术术后病人的可控性、尿动力学、血清电解质及肾功能等进行随访观察。结果：47例均获随访,随访5-24个月,平均17个月,47例患者白天完全可控,43例患者夜间完全可控,溢尿4例。储尿囊容量为270-450 mL,平均320 mL,储尿囊内压力10.27-30.60 cmH2O（1cmH2O=0.098 kPa）,平均20.56cmH2O。B超、IVU及储尿囊造影示无输尿管狭窄及反流。血清电解质及肾功能正常。结论：直肠膀胱-乙状结肠腹壁造口术操作简单、疗效可靠、并发症较少、储尿囊压力较低、控制排尿满意,是一种较理想的尿流分流手术。

Objective： To assess the long-term effeicacy of rectum-bladder-sigmoid colon abdominal ostomy.Methods The controllability,urodynamics,serum electrolyte and renel function were observed in 47 patients.Results： The patients have been followed up for 5-24 months averaged 17 months.All were completely under control during the day and 43 patients were controllable at the night.Only 4 patients had nocturnal incontinence.The mean capacity of the pouch was 320 mL（270-450 mL） and the mean filling pressure of the pouch was 20.56 cmH2O（10.27-30.60 cmH2O）.No ureter reflux and ureteral obstruction was observed and serum electrolytes and renal function were normal in all patients.Conclusion： With easy operation,reliable effect and little complication,rectum-bladder-sigmoid colon abdominal ostomy shows low pressure in the pouch and satisfactory control on urination.It is highly recommended.